DEREK LOGAN MARSHALL (NPI# 1104320639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104320639 |
| Entity Type | Individual |
| Full Name | DEREK LOGAN MARSHALL |
| Credential | MD (AS OF 5/5/18) |
| Practice Address |
4200 Douglas Street Omaha NE 68131 |
| Mailing Address |
4200 Douglas St Omaha NE 68131-2700 |
| Practice Telephone | 4025523222 |
| Practice Fax Number | 4025522172 |
| Mailing Telephone | 4025523222 |
| Mailing Fax Number | 4025522172 |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2018-03-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164790713 | Derek Marshall | Student in an Organized Health Care Education/Training Program | 1316 Virginia St E, Charleston, WV 25301-3054 | 2011-12-11 |
| 1629619374 | Derek Marshall | Student in an Organized Health Care Education/Training Program | 1801 Vicente St, San Francisco, CA 94116-2923 | 2019-10-03 |
| 1255475943 | Derek E Marshall | Anesthesiology | 1151 N State St, Suite 311, Jackson, MS 39202 | 2007-02-16 |
| 1386629194 | Derek Spencer Marshall Sr. | Dentist | 6200 Wilshire Blvd, #1709, Los Angeles, CA 90048-5801 | 2005-12-14 |
| Street Address |
4200 DOUGLAS STREET |
| City | OMAHA |
| State | NE |
| Zip Code | 68131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821020512 | Amy K Jespersen | Family Medicine | 4200 Douglas Street, Clarkson Family Medicine, Omaha, NE 68131-2700 | 2006-07-06 |
| 1689606642 | Jerry L Authier | Psychiatry & Neurology | 4200 Douglas Street, Omaha, NE 68131-2700 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626086 | Spring Forward Ot, LLC | Occupational Therapist | 429 N. 38th Ave, Omaha, NE 68131 | 2020-03-31 |
| 1568944528 | Amy Vodicka | Case Manager/Care Coordinator | 3612 Cuming St., Omaha, NE 68131 | 2018-09-05 |
| 1982121919 | Lakeisha Marie Phelps | Peer Specialist | 3568 Dodge St, Omaha, NE 68131 | 2017-08-30 |
| 1063939098 | William L. Rolfe | Community Health Worker | 3568 Dodge Street, Suite 2, Omaha, NE 68131 | 2017-08-30 |
| 1578086294 | Nebraska Family Support Network | Community/Behavioral Health | 3568 Dodge St Ste 2, Omaha, NE 68131 | 2017-07-25 |
| 1124558937 | Beverly Hamilton | Case Manager/Care Coordinator | 3612 Cuming, Omaha, NE 68131 | 2017-06-14 |
| 1396291068 | Elizabeth George | Internal Medicine | 601 N. 30th St. Cu Department of Internal Medicine, Omaha, NE 68131 | 2016-08-31 |
| 1639625999 | Samuel Ramon Brown | Surgery | 601 N. 30th St. Cu Department of Surgery, Omaha, NE 68131 | 2016-08-28 |
| 1205289238 | Srilakshmi Reddy | Surgery | 601 N 30th St -cu Department of General Surgery, Omaha, NE 68131 | 2016-07-14 |
| 1881069409 | Jordan Sieh | Behavioral Analyst | 444 S. 44th St, Omaha, NE 68131 | 2015-12-08 |
| Find all providers in zip 68131 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851902647 | Katia Lira Garcia | Student in an Organized Health Care Education/Training Program | 9153 Black St, Omaha, NE 68122-1823 | 2020-08-13 |
| 1508477589 | Nicole Amato | Student in an Organized Health Care Education/Training Program | 3306 S 52nd St, Omaha, NE 68106-3806 | 2020-08-12 |
| 1790393692 | Akshay Machanahalli Balakrishna | Student in an Organized Health Care Education/Training Program | 7710 Mercy Road, Suite 202 - Cu Department of Internal, Omaha, NE 68124-2353 | 2020-07-16 |
| 1124644703 | Michaelyn Aleah Everhart | Student in an Organized Health Care Education/Training Program | 9885575 Nebraska Medical Center, Omaha, NE 68198-5575 | 2020-06-19 |
| 1043836992 | Glen Sheridan Clinton | Student in an Organized Health Care Education/Training Program | 981150 Nebraska Medical Center Omaha Ne 68198-1150, Omaha, NE 68198-0001 | 2020-06-16 |
| 1548885809 | Adam P Zobel | Student in an Organized Health Care Education/Training Program | 984150 Nebraska Medical Ctr # 5597372, Omaha, NE 68198-4150 | 2020-06-12 |
| 1972127918 | Krysta Mary Sutyak | Student in an Organized Health Care Education/Training Program | 986880 Nebraska Medical Center, Omaha, NE 68198-3280 | 2020-06-05 |
| 1023630209 | Tuan Anh Quang Ta | Student in an Organized Health Care Education/Training Program | 4400 Emile St Rm 3601, Omaha, NE 68198-0600 | 2020-05-11 |
| 1902434186 | Andrew William Enzler | Student in an Organized Health Care Education/Training Program | 623 S 56th St, Omaha, NE 68106-1318 | 2020-04-01 |
| 1952937732 | Ran Jing | Student in an Organized Health Care Education/Training Program | Unmc College of Medicine 985520 Nebraska Medical Center, Omaha, NE 68198-5520 | 2020-03-12 |
| Find all providers in OMAHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.